Early childhood diarrhea is associated with diminished cognitive function 4 to 7 years later in children in a northeast Brazilian shantytown.

Abstract

Abstract. Diarrhea is well recognized as a leading cause of childhood mortality and morbidity in developing countries; however, possible long-term cognitive deficits from heavy diarrhea burdens in early childhood remain poorly defined. To assess the potential long-term impact of early childhood diarrhea (in the first 2 years of life) on cognitive function in later childhood, we studied the cognitive function of a cohort of children in an urban Brazilian shantytown with a high incidence of early childhood diarrhea. Forty-six children (age range, 6-10 years) with complete diarrhea surveillance during their first 2 years of life were given a battery of five cognitive tests. Test of Non-Verbal Intelligence-III (TONI) scores were inversely correlated with early childhood diarrhea (P ‫ס‬ .01), even when controlling for maternal education, duration of breast-feeding, and early childhood helminthiasis (Ascaris or Trichuris). Furthermore, Wechsler Intelligence Scale for Children (WISC-III) Coding Tasks and WISC-III Digit Span (reverse and total) scores were also significantly lower in the 17 children with a history of early childhood persistent diarrhea (PD; P < .05), even when controlling for helminths and maternal education. No correlations were seen between diarrhea rates and Wide Range Assessment of Memory and Learning subtests or WISC-III Mazes. This report (with larger numbers of participants and new tests) confirms and substantially extends previous pilot studies, showing that long-term cognitive deficits are associated with early childhood diarrhea. These findings have important implications for the importance of interventions that may reduce early childhood diarrheal illnesses or their consequences.

Effects of Early Malnutrition on Mental System, Metabolic Syndrome, Immunity and the Gastrointestinal Tract

“…Stunting, diarrheal disease, and parasitic infections caused mostly by malnutrition were also related to poor mental function [9]. In addition, a follow-up study that specifically addressed the possible long-term impact of early childhood diarrhea on cognitive function in later childhood suggested that childhood diarrhea was linked to deficits in cognitive abilities several years later [9,56].…”

Rotavirus Prevalence in the Primary Care Setting in Nicaragua after Universal Infant Rotavirus Immunization

“…1 Less severe cases of diarrhea, which are more likely to be treated in primary care clinics, are responsible for substantial morbidity. [2][3][4] To reduce the burden of rotavirus diarrhea, a growing number of nations are adding the rotavirus vaccine to their national immunization schedules. In clinical trials conducted primarily in the United States and Europe, the pentavalent rotavirus vaccine (RV5) reduced clinic visits for rotavirus diarrhea by 86%.…”

Neurodevelopment, Nutrition, and Inflammation: The Evolving Global Child Health Landscape

“…65,66 Despite surprisingly comparable growth curves in the first few months of life, the fall from the expected growth trajectory from 4 to 24 months of age in children living in impoverished areas of Asia, Africa, and Latin America has been remarkably consistent in decade-plus reviews as well as in current multisite studies. 3,67 The extent to which stunted growth is a reflection of intestinal parasitic or other infections or is predictive of impaired cognitive development, or that the latter may occur with an EE independent of stunted growth, has been and remains the topic of many studies ranging from work in Guatemala, 53 the Philippines, 51 Kenya, 63 Jamaica, 64,67 Peru, 68,69 and Brazil 70,71 to the current work by the Interactions of Malnutrition and Enteric Infections: Consequences for Child Health and Development consortium. 72 Evidence continues to mount that enteric infections and enteric or systemic inflammation in early childhood or prenatally can impair growth and development and perhaps even increase later life associations with obesity, metabolic syndrome or cardiovascular disease.…”